healthcare, politicians

“Whatever you think is best, doctor.”

I was kind of hoping this morning I’d find something amusing to write about. My last few posts have been downers. Maybe later, once I’ve had a little more time to wake up and cheer up, I’ll find something funny about the world today. Right now, I’m compelled to write about an opinion piece I read in The New York Times.

Dr. Jen Gunter is an OB-GYN who has recently written a number of pieces about her experiences as a doctor who provides abortions. I usually like what she writes about this subject, since she is very knowledgable and reasonable. This morning, I read her piece entitled “Medical School Doesn’t Teach the ‘Woman’s Life Is In Danger’ Curriculum“. As usual, Gunter made a lot of sense. She also brought up some issues with these new abortion bills that I don’t think a lot of people have considered.

In her op-ed, Dr. Gunter wrote about a case she had in 1998. She was called in to perform an abortion on a woman who was very sick and in her first trimester of pregnancy. The woman’s condition was rapidly deteriorating and the pregnancy was making her situation worse. Although her life was not in immediate danger, her caregivers feared that if she continued her pregnancy, her condition would quickly decompensate and she would need dialysis due to kidney failure.

The problem was, this was happening in Kansas, where a new restrictive abortion law was enacted that forbade abortions from being done on state government property, unless the mother’s life was in danger. The medical center where Dr. Gunter worked was on state property. While it’s very possible to manage kidney failure on dialysis, it’s not the ideal course of action. It’s better to prevent kidney damage, which would then prevent a host of other serious medical problems that would put the patient’s life in danger. The patient was not about to die, but her condition might eventually cause death if the doctor didn’t act. On the other hand, thanks to the law, if Dr. Gunter made the “wrong” decision, she could be fired or wind up in legal trouble. She could even be arrested, which would be a real problem, since malpractice insurance does not cover criminal prosecution.

The law was vague regarding what Dr. Gunter should do. She spoke to the hospital’s attorneys, who advised her to call the legislator who had written the law. So, instead of prepping her patient for surgery and taking care of her patient’s private medical issues, Dr. Gunter was forced to call up a legislator who had absolutely no clue about this wrinkle in the law because he wasn’t a medical professional. Moreover, Dr. Gunter was about to talk about this lady’s private medical situation with a man who was completely uninvolved, except for the fact that he’d written the law that was holding up Gunter’s ability to take action. To add insult to injury, he didn’t even seem to care! As Gunter launched into a description of the woman’s medical issues necessitating an abortion, the legislator interrupted her and said, “Whatever you think is best, doctor.”

The woman got her abortion and her medical condition improved. But Dr. Gunter was left fuming, since she’d had to waste precious time calling up a legislator who obviously didn’t actually care that much about this law. He hadn’t even listened to her speak for more than a minute before he basically said “whatever”. Meanwhile, this lady’s health– her very life– was in danger. What would have happened if Dr. Gunter had not taken the time to cover her ass by calling the lawmaker? What if she’d simply done the abortion and gotten arrested for breaking the law, even though she’d made the correct medical decision? What if she’d not done the abortion and her patient died? Then she might be on the hook for medical malpractice. She’d also have to deal with the guilt of knowing that she has the training to help women in these dire medical situations, but can’t act due to restrictive, misguided legislation like the “heartbeat” bills being considered and passed in places like Georgia, Ohio, and Alabama.

I wonder if the untrained politicians who are making these laws have considered the second and third order effects of forcing women to birth. One thing I think will happen, right off the bat, is that malpractice coverage will have to be expanded. Perhaps another type of insurance will be created to help physicians who are criminally charged in situations like the one Dr. Gunter describes. That will mean higher healthcare costs for everyone, since everyone practicing in a healthcare setting will need coverage.

Next, legislators will start getting phone calls at all hours from medical professionals who need clarification of the laws. Senator So and So might be enjoying a night out with his wife and have to answer a frantic phone call from a doctor who is trying to treat a pregnant woman whose pregnancy is making her health worse. And the doctor will have to listen to an untrained legislator offering his opinion.

Patient privacy will go out the window. It will have to, since physicians will have to seek advice from legal people on what they should or shouldn’t do for a patient like the one Dr. Gunter describes. Moreover, doctors, who already have a lot to do and huge loans to repay, will have to waste time with legal red tape and possibly money trying to defend themselves from legal action. A lot of them will have to go to court and may even risk being arrested simply for trying to do their jobs.

I haven’t even touched upon what will happen when sick women with health problems are forced to give birth. They will probably need more healthcare, since the pregnancy has made their condition worse. And their babies will probably need more healthcare, too– if they survive. That will mean more work for healthcare providers and higher costs for both insurance companies and uninsured people. Uninsured people will likely have more bad debt, which could ruin their ability to make major purchases like cars, education, or homes. That will affect business… well, maybe not for undertakers, who will probably get more business as more people die.

The legal system will get more business as more cases regarding abortion wind up in court. More people will go to prison, which is already a shameful big business in the United States, where in 2016, 2.2 million people were already behind bars. Maybe it’s not such a bad thing for the people who profit off of incarcerating others– privately run prisons are a thing in the United States. However, it will not be a good thing for families and individuals directly affected by having a loved one in prison. A lot of the “babies” legislators were so keen to see born could wind up with parents in prison, if they’re lucky– the cemetery if they’re not.

I can see why people are “pro-life”. A lot of folks believe it’s a matter of personal responsibility to prevent pregnancy. I happen to agree that, at least for me, it wasn’t hard to avoid getting pregnant. But I don’t represent everyone. Sometimes even when a person uses birth control– or even after they get a procedure like a vasectomy or a tubal ligation– pregnancy can still happen at the worst possible time. Sometimes birth control methods fail. Sometimes even vasectomies and tubal ligations can fail, though that is admittedly a rare situation.

And so many of them think that because they more often pay child support, they should have the right to enslave a woman by forcing her to give birth.

I’ve been paying attention to a lot of rhetoric spouted by “pro-lifers”, many of whom are men. I’ve seen a lot of men equating their duty to pay child support to a woman’s duty to give birth. First off, men aren’t the only ones who pay child support. Sometimes women pay child support. Secondly, having to pay child support is really no comparison to having your health on the line while gestating a baby. And before the baby is born, the name on the hospital’s and doctor’s bills is not that of the father’s.

I’ve seen other people, again mostly men, tossing out the statistics of when an abortion is “medically necessary”. One guy claimed it was about 4%. He did not provide the source of his statistic, but even if he had, I would be skeptical about its veracity. I don’t see how it’s possible to really know how many abortions are simply done for convenience. Everyone who seeks one has a story. Besides that, I can’t imagine any woman having an abortion for “fun” or even convenience.

I’m as big on personal responsibility as anyone is. I just think that abortion, just like any other medical procedure, should be entirely private. We don’t force people to donate organs to others, even when doing so would save another person’s life. We don’t begrudge people who defend themselves against intruders by using deadly force– one could argue that when a pregnancy threatens a woman’s life, that person has the right to use deadly force for her own self-protection. We have a big, complicated law called HIPAA that is supposed to protect our right to privacy in a medical setting. There is no reason why Dr. Gunter, an eminently qualified physician with excellent medical judgment, should have to call some legislator for permission to take care of her patients, particularly when the legislator isn’t even trained in medicine.

I’ll close with a direct quote from Dr. Gunter’s opinion piece. “Abortion is sometimes medically necessary, and women will have abortions whether they are safe and legal or not. Creating legislation that suggests otherwise does not change that truth.” Not allowing physicians to make medical decisions for their patients is a terrible idea.